Carbamazepine and the active epoxide metabolite are effectively cleared by hemodialysis followed by continuous venovenous hemodialysis in an acute overdose

被引：22

作者：

Harder, Jennifer L. ^{[1
]}

Heung, Michael ^{[1
]}

Vilay, A. Mary ^{[2
]}

Mueller, Bruce A. ^{[3
]}

Segal, Jonathan H. ^{[1
]}

机构：

[1] Univ Michigan, Div Nephrol, Dept Internal Med, Sch Med, Ann Arbor, MI 48109 USA

[2] Univ New Mexico, Coll Pharm, Dept Pharm Practice & Adm Sci, Albuquerque, NM 87131 USA

[3] Univ New Mexico, Coll Pharm, Clin Social & Adm Sci Dept, Albuquerque, NM 87131 USA

来源：

HEMODIALYSIS INTERNATIONAL | 2011年 / 15卷 / 03期

关键词：

Pharmacokinetics; carbamazepine; hemodialysis; CVVHD; overdose; HEMOPERFUSION; CARBAMAZEPINE-10,11-EPOXIDE; PHARMACOKINETICS; INTOXICATION; ADOLESCENTS; THERAPY;

D O I：

10.1111/j.1542-4758.2011.00563.x

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Hemodialysis (HD) and continuous venovenous hemodialysis (CVVHD) have an unproven role in the management of carbamazepine overdose. Albumin-enhanced CVVHD may accelerate carbamazepine (CBZ) clearance, but no pharmacokinetic data has been reported for traditional CVVHD without albumin enhancement. In addition, it is unclear whether the active CBZ-epoxide metabolite is removed with either mode of dialysis. We present a case of CBZ intoxication successfully managed with sequential HD and CVVHD. The CBZ half-life during CVVHD was 14.7 hours, compared with the patient's endogenous half-life of 30.8 hours. The CBZ-epoxide half-life was 3.2 hours during HD. We conclude that HD and CVVHD provide effective clearance of CBZ and the epoxide metabolite and should be considered in the management of an acute toxic ingestion.

引用

页码：412 / 415

页数：4

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